AVN Question

[Terry_Smith]

   If one has AVN, and is still able to walk with some discomfort, could one think that resurfacing is still an option, or can you still get around with some discomfort and have your femur beyond the point that a resurfacing is feasable?  I'm just curious, and wonder what anyone with AVN would know.

Terry

[Vicky]

Hi Terry,

From what  I understand ( and I am no medical expert) the AVN has to reach a certain stage before a resurface is possible, the cartiledge needs to be worn out as well, but then again, it can also go beyond the stage where a resurface is possible.  So the best thing for you to do is to get a consult from an experienced resurfacing surgeon to find out where you are at.  AVN is not a standard case that all docs will take, so you would be wise to seek out the opinion of some of the top resurfacing surgeons in the world.  They offer free consults.  The world expert on AVN cases and the surgeon who has successfully resurfaced the most AVN cases out of any other surgeon in the world (over 350) is Dr. Vijay Bose in India, he was my doctor.  I traveled from California to India to have him do my resurfacing.  He is top notch.  Where do you live? 

Vicky
LBHR Dr. Bose Dec 01 05

[Pat Walter]

Hi Terry

I did not have AVN either, but I also recommend that you use a very experienced surgeon when you have special problems.  There are different stages of AVN and times when surgery are recommended. You can read Dr. Bose article about AVN and when to operate here
http://www.surfacehippy.info/avn.php

Dr. Bose of India, Dr. Gross of SC and Dr. De Smet of Belgium are a few of the top surgeons that will give free consultations.  If you send them emails with your x-rays attached in a digital format in  .jpg, they will get back to your farily quickly with an evaluation.  Dr. Gross will take longer and will eventually call you on the phone.

Please keep in touch.  Let us know what other information you might need.

Pat

[Terry_Smith]

  Thank you for the responses   I'm getting an MRI on Monday, awaiting an appointment for a bone density scan, and I will be sending these plus my x-rays to Dr. Gross in SC once I have them for consultation.  I also still have my appointment on the 27th with Dr. Ball in San Diego, but if I can get the consult done with Dr. Gross before then, I'd rather not wait.  I'm geting tired of limping around instead of striding around.  That and having my left leg a bit shorter now due to the change in my femur isn't thrilling me either 

Terry

[Pat Walter]

Hi

Sometimes it takes Dr. Gross a few weeks to get back to you.  It just depends on how busy his schedule is.

Dr. Bose and De Smet get back to you often the next day.

Good Luck.  You will soon be "running around" with a new hip resurfacing.  And be out of pain.

They will make sure your leg is the right length during surgery.

Pat

[Terry_Smith]

Pat,

    Well, since no Doctor has yet actually requested a bone density scan, I won't be getting that yet - I was probably getting ahead of myself on that point - need a Doctor referral for that.  Monday is the MRI, and as soon as I get those films in my hands and a copy of my x-rays, I'm FedExing them overnight to Dr. Gross in SC.  I've already talked to his office and have the address they want them sent to. Hopefully they will have them there by end of next week.  I'm still doubtful that anything other than a MOM will be an option for my left hip, from what I saw on the x-rays, but I'm not the specialist in this field.  I will post again after I hear from his office and see what he says.

Terry

[Pat Walter]

Hi Terry

I think you are doing the right thing to get input from Dr. Gross. He is an excellent doctor.

I will also say again, that you could send a copy of your x-rays off to Dr. Bose in India and Dr. De Smet in Belgium and you will have a free consult much faster than Dr. Gross.  The doctors know people often write to all of them.  They understand that and also that in difficult cases people need as much input as possible before making a decision.

I think I have said before but will repeat - sometimes Dr. De Smet or Bose won't do a hip resurfacing while Dr. Gross will.  And sometimes Gross won't while De Smet or Bose will.  Sometimes people have to check all three if they really want a hip resurfacing. There have been a handful of people that have taken that route and did get their hip resurfacing.

So don't give up until you have tried all sources.  I can't remember if you told us how young you were - I am 61 and even at my age I would not accept a THR.  I am too young and active to go that route. The younger you are, the more likely that you will face a revision in your life.  You first revision from a BHR to a THR is much easier.  You have a complete femur bone left for the revision. That is the main reason I choose Hip Resurfacing even at 61.  Heck - I might live to be 85 like my Mom or even much older. 

Good Luck and keep in touch.

Pat

[Terry_Smith]

Pat,
  I'm 44 right now, and personally do not want the THR, which is why I'm contacting Dr. Gross, and seeing Dr. Ball in San Diego as well.  I just had some financial issues pop up, and trust me, a trip overseas, now is impossible.  I had to do some re-structuring of finances to avoid the possibility of losing my home.  That aside (we should be just fine now), my options are surgeons in the USA, and Dr. Gross is who I'm leaning towards now.

Terry

[Pat Walter]

Hi
Just know that if you need info from people that have "been there and done that"  I have been to Dr. De Smet in Belgium in 2006 because I could not afford surgery in the US.

Vicky has "been there and done that" with Dr. Bose in India. 

Either of us can help you with info if your options in the US don't pan out.

We both could not be happier with our surgeries and doctors. Both of us, along with many hundreds of other De Smet and Bose Hippies, would return if we needed another hip done.

Pat

[Terry_Smith]

Pat,
   I'm planning on sending x-rays to Dr. Bose (and hopefully my MRI) once I get the MRI done.  I'd like to see what he has to say.  Vicki suggested it.  She told me about the BMHR procedure that some are doing overseas.  I really don't have the finances to go over there, but India is certainly the lesser of 2 evils, cost-wise.  Depending upon the results I hear about, I may decide to sell one of my cars to pay for the surgery - after all, a car will wear out long before the hip does.  I'd rather not do that, but since some un-forseen financial woes were thrust upon me, my options for credit are limited.  I'll have to wait and see. I think that my left hip won't do a BHR, but would probably do BMHR, and I know Dr. Bose is doing them.  I'll keep you posted.

Terry

[Pat Walter]

Terry

I felt the same as you do. I did not want a THR even though I could have had a free or almost free one here.  We were very deep in debt since my husbands company went out of business and dropped our insurance. Fortunatly, I had a  drawer full of unused credit cards.  Now they are very used and we are very deep in debt since we lived off them for 6 months, started a new business with them and also went to Belgium to get my hip with a total spent of $18,000

I feel it is the best financial investment I ever made in my life.  We may never get our debt paid off before we die, but I don't care.  I am 63 now and have my BHR. I never took heavy pain pills after several days after surgery.  My hip is perfect. It was worth it.  The peace of mind is worth it to know I got the best I could get.

A car will depreciate - but your new hip only gets better and better. Hip decisions depend on your prioity - and I think your health comes first over any other purchase.

Good Luck. Dr. Bose is one of the very best with AVN. He also just did his first BMHR recently.

Pat

[Terry_Smith]

  Well, I DO NOT HAVE AVN!!!  I saw the Doctor who ordered the MRI, and there was no evidence of AVN, just bad Arthritis.  He still feels that I need a THR on the left side, but I'm going to send my results to Dr. Gross, and take a copy of my stuff to Dr. Ball in 2 weeks, 1 day.  This doctor said that a THR would be needed because of the bone wear, to even my legs, but most of the wear is my old femur.  I'd think that if it was resurfaced, and a new "ball" was in place, and a new socket, then the length would be back to what it was prior to the wear.  He was also not very helpful in releasing my X-Rays and MRI to me.  But, I finally got them to give me a form to fill out so when the Doctor returns them to the X-ray department, they can send them to Dr. Ball.  Hopefully, since there is no AVN, I can get the BHR on my left hip as well as the right.  Will keep you posted.

Terry

[Pat Walter]

Hi Terry

That's good news about not having AVN.  The Surgeon can lengthen your leg when you have a hip resurfacing.  Number of people have had that done. 

I Hope Dr. Ball will have good news for you and also Dr. Gross.


At least you have one less thing to worry about. 

Thanks for updating us.  We will be sending Good Luck your way.

Pat

[Terry_Smith]

   All my films are on their way to Dr. Gross.  He should have them tomorrow morning.  I don't know if I have enough femoral bone left on the left hip to do the BHR (he likes 2/3 left).  Looking at my x-ray, it looks close.  I hope to hear from him within a week (if I'm lucky).  I guess it depends on his schedule.  It's been a week since I sent my pictures to Dr. Bose.  I'm hoping I hear from him to see what he says about my x-rays.  I can't believe that the doc I saw today said that the BHR wouldn't fix the length of my leg with the bone loss from the femoral head, especially since others here have mentioned that having their leg lengthened after the procedure has helped them.  Pat, I'm SO glad you have this site and Surface Hippy going. 

Terry

[Pat Walter]

I do hope all goes well for you.

If you don't hear from Dr. Bose shortly, you could drop him another email.  There was another big ortho conference and I don't know whether he was there or not.

I am very happy that I can help people learn about hip resurfacing so they don't have to always accept what their orthos tell them.  I don't know why he told you that he couldn't fix your leg length, but again, I do know others have had their legs lengthened.

The only way to help people is to share information - that's why I work so hard at the websites.  I can't give medical advice, but knowing as much as you can about hip resurfacing gives you information that helps you choose a doctor and hopefully, a hip resurfacing.  Knowledge is Power!!!!    Patients helping patients is powerful too!

Keep in touch and I know we all wish the best for you.

Pat

[Vicky]

Hi Terry,

I would send another email to Dr. Bose, the first one could have gotten lost.  Dr. Bose lengthened my leg so it can be done with resurfacing.  Let us know what you hear from Dr. Gross, I know he is swamped after attending the conference last weekend.

Vicky